PB2252: A PATIENT WITH SEVERE APLASTIC ANEMIA UNDERWENT ALLOGENEIC HEMATOPOIETIC TRANSPLANTATION. EVIDENCE-BASED NURSING CARE OF PATIENTS COMPLICATED WITH ORAL AND LABIAL TISSUE ULCERATION
Authors: LI Wang, Xiaoli Chen, Fangfang Wu, Hengrui Sun, Yimei Feng, XI Zhang
Journal: HemaSphere (2023)

Topic: 16. Myeloproliferative neoplasms - Clinical Background: Oral mucositis (OM) is one of the common complications of hematopoietic stem cell transplantation with high incidence. OM can often cause unbearable oral pain, which not only obviously affects patients’ eating and swallowing, but also may lead to malnutrition and infection risk, thus affecting hematopoietic reconstruction and treatment effect, prolonging hospitalization time and reducing quality of life. At present, domestic experts have reached a consensus on the diagnosis and prevention of acute oral mucositis caused by anti-tumor therapy, including a variety of methods and strategies, but the results are controversial, and the best method is still unknown. There are no standardized and systematic measures for the treatment of oral mucositis in patients undergoing hematopoietic stem cell transplantation. Aims: The clinical application and nursing practice of evidence-based combination of local and systemic drugs in oral and labial tissue ulceration combined with massive black scab. Methods: Summarize the nursing practice scheme of a patient with severe aplastic anemia who underwent allogeneic hematopoietic stem cell transplantation combined with large black scab, and search related literatures by searching Cochrane evidence-based medicine, MedLine, PubMed, Web of science, China HowNet, China Biomedical Literature Database, Wanfang, etc., and then determine the best evidence by two researchers using evidence-based nursing (RNAO)2007 edition) and JBI evidence recommendation level, 2010 edition. Combine the actual situation of patients with the best clinical nursing evidence. In our ward, the ulceration of oral lips continued to ooze blood, and Ipsu oral gel was used to stop bleeding. The ulceration area was treated with povidone iodine solution, Kangfuxin solution, acyclovir diluent, gentamicin solution and other mouthwashes, and shellfish and other symptomatic drugs and oral care. Results: After more than 40 days, the patient’s black scab on his lips softened with paraffin oil and fell off in the form of a cap, and the ulcerated tissues in his mouth and pharynx fell off by themselves. The granulation of his mouth, mouth and pharynx grew and covered with mucous membrane, and the wound healed. The patient complained of no pain, and he could chew normally into a liquid diet and transition to a semi-liquid diet, and he could communicate normally. He could drum his cheeks and gargle by himself. Summary/Conclusion: In the immunosuppression period after allogeneic hematopoietic stem cell transplantation, mechanical scabbing should be avoided. According to the patient’s test results, anti-bacteria and anti-virus combined with local treatment can shorten the wound healing time, save medical expenses, reduce malnutrition caused by oral ulcer and complications related to endogenous infection caused by oral ulcer, reduce the hospitalization time of patients, and improve the treatment effect and quality of life of patients. Keywords: Allogeneic hematopoietic stem cell transplant, Aplastic anemia